title: Invasive bladder cancer in the eighties: transurethral resection or cystectomy?
abstract: OBJECTIVE
  Describe morbidity and survival in patients older than 80 years with muscle invasive bladder cancer (MIBC) treated with radical cystectomy (RC) or transurethral resection (TUR) in our institution.
  
  
  METHODS
  We reviewed our database of all patients older than 80 years treated with RC and TUR for MIBC between 1993 and 2005 in our institution. Twenty-seven patients were submitted to RC, with mean age of 82 years and mean follow-up of 16.4 months. RC was carried out following diagnosis of previous MIBC in 14 cases (51.9%). The American Society of Anesthesiology (ASA) score was III or IV in 23 patients (85.1%). Seventy-two patients with a mean age of 84 years and mean follow-up of 33 months, diagnosed with MIBC, were managed by means of TUR. The ASA score was III-IV in 64 (88.8%) patients.
  
  
  RESULTS
  Pathological stage of the RC specimen was pT3 in 18 cases (66.7%). Mean hospital stay was 16 days. Early complications were assessed in 8 patients (29.6%), with an overall survival (OS) of 42.94%, and cancer-specific survival (CSS) of 60.54%. In patients submitted to TUR, clinical stage was T2 in 36 cases (50%). The mean hospital stay was 7 days, with a readmission rate (RR) of 87.5%. OS and CSS was less than 20%.
  
  
  CONCLUSIONS
  RC in octogenarian patients is a safe procedure, with complication and survival rates comparable to RC series in general population. Transurethral resection (TUR) for patients with MIBC within this age range is a much less morbid procedure, but disease specific survival is lower.
authors.affiliation: Department of Urology, Universitat Autonoma de Barcelona, Barcelona, Spain. orodriguez@fundacio-puigvert.es
authors.forename: Oscar Rodriguez
authors.initials: OR
authors.lastname: Faba
authors.forename: Joan
authors.initials: J
authors.lastname: Palou
authors.forename: Guillermo
authors.initials: G
authors.lastname: Urdaneta
authors.forename: Luis
authors.initials: L
authors.lastname: Gausa
authors.forename: Humberto
authors.initials: H
authors.lastname: Villavicencio
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012737:Sex Factors; D013030:Spain; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*